Diagnosis and Treatment
Stroke care starts before the patient arrives at the hospital.
Rochester Regional Health carefully coordinates efforts with local Emergency Medical Services (EMS) to make sure that high-quality care begins en-route to a Rochester Regional Health hospital. We require EMS to notify us of potential incoming stroke patients, so our stroke team can be assembled and ready when the patient arrives. We also provide EMS teams with ongoing education on the latest stroke protocols.
Effective treatment will depend on the type of stroke a patient is having. For all people with stroke, we need to determine why the stroke occurred in order to prevent future strokes.
Our stroke doctors use a wide variety of advanced diagnostic tests and work alongside other Rochester Regional Health specialists to reach a clear and definitive diagnosis.
Diagnostic tests may include:
- CT Scan: an x-ray of the brain that reveals evidence of bleeding or damage of brain cells to help identify the type of stroke and its location
- Magnetic Resonance Imaging (MRI): computerized brain imaging done with magnets instead of x-ray to find small changes in brain tissue
- Carotid duplex ultrasound: examines blood vessels in the neck to see if they are narrowed or blocked
- Transcranial dopplers: examines blood vessels in the neck to see if they are narrowed or blocked
- Transthoracic echocardiogram (TTE): use of ultrasound to examine the heart function and determine if the blood clot formed in the heart
- Transesophageal echocardiogram: ultrasound of the heart through the esophagus, usually prescribed after an abnormality is found in the results of a TTE
- Cardiac monitoring: patches placed on the chest and attached to a monitor to determine heart beat irregularities
- Medication management:
In some cases, patients may receive a clot-dissolving medicine called tissue plasminogen activator (tPA or alteplase). This medicine can help reduce the risk of disability, especially if it's given as soon as possible after the stroke happens. Alteplase can typically be given up to 4.5 hours after stroke symptoms started.
- Endovascular surgery:
In some cases, a minimally invasive procedure may be done to restore blood flow to the brain. Under x-ray guidance, our neurointerventional surgeons insert a thin, flexible tube (catheter) and a clot retrieval device through the femoral artery to remove the blood clot that caused the stroke. This procedure is called a mechanical thrombectomy.
In a minority of cases, when emergency neurosurgery is deemed to be the best treatment option, a specialized surgical team will perform the surgery within two hours.